Ministry of Mis-Information May 16, 2008 7:08 AM   Subscribe

Could people please stop giving medical advice with no basis in science in this thread?

This is a situation where two people have had unprotected intercourse followed by withdrawal. It's the poster child for unsafe sex, and EC is absolutely and immediately warranted.

So unless anyone commenting in that thread has a time machine, declarations that "your girlfriend is not pregnant, relax" are less than helpful.

In addition to that, we've had several sweeping and misleading generalizations, among them:

* Mentions of RU-486, which is not the same thing as emergency contraception, which is not an abortificant;

* Statements that this kind of sex is as safe as sex with a condom, which it is not;

* Assertions that EC universally causes pain, vomiting, and distress, which it does not;

* Statements that risk can be assessed based on the young woman in question's menstrual cycle, which it cannot;

* Statements that an action taken now will be less painful than abortion, which amounts to abortion scaremongering and is not the case with a successful procedure under general anaesthesia;

That thread is, at this point, a hazard of mis-information. If you don't know what you're talking about, please don't comment when you have nothing to add that isn't based on what you read on a bathroom wall when you were in 11th grade.

While seeking medical advice on MeFi is, yes, always a bad idea, the fact is that sometimes an AskMeFi-er can leave a thread with more knowledge about risks and options than they came in with, and thus be better equipped to reach the right healthcare practitioners and be better advocates for themselves. But this only works when the information provided is solid.

These threads have real world implications for the asker that are rather serious, more so with teen sexuality threads than many others because the information provided is often not balanced with independent research. Please, tread carefully.
posted by DarlingBri to Etiquette/Policy at 7:08 AM (96 comments total) 3 users marked this as a favorite

AskMe is not a doctor, and should not be treated as such. Basically, the only way to get an answer with a basis in science is to go to a doctor. Anyone who relies on MetaFilter as a pregnancy test is looking for trouble.

If you want to ask how to configure a server, though, or find out the name of a song based on three lines of nasal humming, AskMe should be considered an excellent resource.
posted by KokuRyu at 7:15 AM on May 16, 2008 [2 favorites]


DarlingBri,
In your opinion, what would have been a good answer to this question?
posted by Brandon Blatcher at 7:16 AM on May 16, 2008


Medical questions rarely go well, and this probably won't change, but the OP marked what is undoubtedly the best answer as such, so this probably isn't a big deal.
posted by SpiffyRob at 7:23 AM on May 16, 2008


AskMe is not a doctor pregnancy test.
posted by ThePinkSuperhero at 7:23 AM on May 16, 2008 [1 favorite]


This has been tried before. It didn't wendell.
posted by dirtynumbangelboy at 7:24 AM on May 16, 2008


That thread was a mess from the beginning. While I appreciate that the OP was just asking for a "what is the liklihood?" sort of response, it was pretty certain that was NOT what was going to happen. People also have strong felings about pregnancy, sex, unprotected sex and STDs and so people bring their own strong opinions ot bear on a thread like that. We tend to not approve the "do you think I am pregnant" AnonyMe questions for exactly the same reason, because the answer is always "no one here can tell you for certain, but a trip to the doctor/drugstore can." While generally speaking I don't mind people giving or getting broad medical advice, it surprised me in that thread seeing people's responses. While I told a few people over email "we don't delete bad answers" there are a few bad answers in that thread. I'd encourage people with solid advice to give the OP feedback and to gently correct some of the misinfo in that thread and take OMG eye-rolling here.
posted by jessamyn (staff) at 7:32 AM on May 16, 2008


This is a situation where two people have had unprotected intercourse followed by withdrawal. It's the poster child for unsafe sex, and EC is absolutely and immediately warranted.

DarlingBri, I appreciate your concern and desire to help this person, but you completely wrong on this. The best advice to give this person is "urge the young woman to speak with her doctor." You are making a misleading and sweeping generalization when you state that EC is "absolutely and immediately" warranted, without knowing any of the specifics of the woman's medical condition. Furthermore, risk can be assessed based on where the young woman is in her menstrual cycle. Fertility medicine is dedicated to just this sort of "risk assessment", though there it is presented as an opportunity assessment. It does matter where she is in her cycle, and it is ridiculous to assert otherwise.

Are some people providing inaccurate and potentially misleading information? Of course. In this MetaTalk thread, you are one of them. Again, the best advice is for the woman to seek professional medical advice regarding the risks and benefits of emergency contraception in her particular case.
posted by Mister_A at 7:35 AM on May 16, 2008 [2 favorites]


Brandon Blatcher --

For example:

Depositing ejaculate on the labia or vaginal opening of your partner gives you a pregnancy risk factor greater than zero. That makes emergency contraception the smart and obvious choice. In this case, there was also unprotected intercourse, which significantly increases your risk factor and makes EC doubly smart.

...would both answer the question and provide accurate information, no?

I realise the Ask is neither a doctor nor a pregnancy test. As evidence of this, I offer up the fact that I have never, ever urinated on my laptop. ClearBlue Digital remains the most sophisticated piece of technology I have ever peed on.
posted by DarlingBri at 7:36 AM on May 16, 2008


Furthermore, risk can be assessed based on where the young woman is in her menstrual cycle. Fertility medicine is dedicated to just this sort of "risk assessment"

While that's certainly true what's not true is that a women is just going to "know" exactly what part of her cycle she's in. She can guess, but it can be irregular.

Even if there is a low probability of pregnancy, if you don't want to be pregnant at all, then taking an EC isn't unwarranted. There's no reason not to want to take the chance of getting pregnant from 2% down to 0.01%. The poster said there might be some heart trouble. Could that be a good reason to not to take EC? I don't think it's an issue, but I don't know. That would be the only real reason not to take it, even if actual pregnancy is unlikely the point is to make pregnancy extremely unlikely.
posted by delmoi at 7:40 AM on May 16, 2008


The problem with saying "Talk to your doctor" (or pharmacist) is that the kids appear to be in the USA. They need to go to Planned Parenthood.
posted by dirtynumbangelboy at 7:41 AM on May 16, 2008


In my alleged "best answer" I also contributed information suggesting that risk can be assessed based on the timing of intercourse in relation to the menstrual cycle. It's not fool-proof, but doctors use it professionally, and lots of people use it personally, and it does give some information about risk. In this case it served to increase, not decrease the perception of risk, which isn't a bad thing.

I totally agree that medical questions are often danger areas on AskMe, but in this case I think the consensus, including DarlingBri's good answers have led the OP to do the sensible thing and help his girlfriend get emergency contraception. Everyone pitching it to suggest doing nothing is only going on their own personal experience, not what they read on a bathroom wall, and those are valid, if slightly unsafe, answers too.

Also based on his previous AskMe history the OP is not a teenager. He could easily have gotten worse advice at Yahoo Answers.
posted by roofus at 7:46 AM on May 16, 2008


By the same (lower-stakes) token, could people stop randomly throwing half-baked and uninformed nonlinguistic ideas in this thread?
posted by kittyprecious at 7:51 AM on May 16, 2008 [2 favorites]


::snort::
posted by ThePinkSuperhero at 7:54 AM on May 16, 2008 [1 favorite]


I wonder if it isn't time to instate a "no pregnancy questions" rule? I don't know what the long haul result of that would be, but I'd imagine that deleting pregnancy threads with a gentle email to the asker saying "We're sorry. We had to delete your question because there's too great an opportunity for you to get really inaccurate information and do something foolish because of it. You should really ask a doctor, and we hope everything works out," might be better for kids like this.
posted by shmegegge at 8:01 AM on May 16, 2008


This is stupid. There is a definitive yes-or-no answer to the question of whether the girl's pregnant, but the thing is that none of us can provide it. The solution is clear. And blue. And, most of all, easy. I don't see why anything happened here other than a genuine "good luck with that" and a closed thread.
posted by kittens for breakfast at 8:17 AM on May 16, 2008 [6 favorites]


I don't think there's any acceptable dividing line between the teen pregnancy threads and other health questions. People like asking and answering health stuff, and we have extensively discussed the problems before (1, 2).
posted by roofus at 8:26 AM on May 16, 2008


and EC is absolutely and immediately warranted.

You are potentially giving some bad advice of your own. The poster mentions that the woman takes daily medications for a heart condition. Without knowing more, that may be a contraindication for EC, or, conversely, may make it more important that she avoid pregnancy.

That askme is even more of a trainwreck than most medical questions for a number of reasons.
posted by TedW at 8:36 AM on May 16, 2008


AskMe is not a pregnancy test.

That's a relief. I peed on it and it turned blue so I was worried.
posted by burnmp3s at 8:36 AM on May 16, 2008 [10 favorites]


yellow and green do not make blue.
posted by shmegegge at 8:40 AM on May 16, 2008


...would both answer the question and provide accurate information, no?

None of us know the woman's health, which could be and seems to be, an issue. Your overall point is good though.

It would probably be best if everyone just advised them to see a doctor, despite the low probability and pointed out a good sex education guide.

AskMe is not a pregnancy test.

In Soviet Russia, pregnancy tests you!
posted by Brandon Blatcher at 8:51 AM on May 16, 2008


In Soviet Russia, pregnancy tests you!

According to my wife/mother of our child, pregnancy tests you in pretty much any country.
posted by TedW at 8:54 AM on May 16, 2008 [6 favorites]


I wonder if it isn't time to instate a "no pregnancy questions" rule?

I get the risks of people getting bad info in threads like this, but this strikes me as a terrible, terrible rule.

It'd be awesome if every teenager who freaks out about pregnancy had a close, personal relationship with a good OBGYN and could get some timely, unbiased info from them. However, given the problems that even assertive adult women in their 20s and 30s sometimes have getting access to unbiased info and things like the morning-after pill, I don't particularly think it's a good policy to assume that if we don't allow them to ask here they'll get good info from their doctor. Personal experience tells me this is not necessarily the case (unfortunately). And that's even if a teenager can get into a doctor--I lived in the Midwest for a while, where the nearest Planned Parenthood was completely inaccessible without a car, and public transportation was non-existent.

There's a lot of crap info in that thread, but there's also people refuting it with good info. It's not the best solution, but letting people ask here (and get crap answers as well as good ones, so at least they can try to judge for themselves or have an awareness of what to ask their doctor about) seems a hell of a lot better than crossing our fingers and praying they'll be able to find an appropriate, unbiased resource in their immediate area in time.
posted by iminurmefi at 8:59 AM on May 16, 2008 [1 favorite]


If I'm reading correctly, there was no intercourse.
posted by mattbucher at 9:01 AM on May 16, 2008


AskMe is not a pregnancy test.

That's a relief. I peed on it and it turned blue so I was worried.

Well, I wouldn't be too relived, I mean, if you look closely, there are [+] all over the place here. This might be one of the most pregnant places I've ever seen.
posted by quin at 9:03 AM on May 16, 2008


There's a lot of crap info in that thread, but there's also people refuting it with good info.

which, to someone who doesn't know any better, creates a situation of undifferentiated noise.

sure, it'd be awesome if askme was the place to go to so that you could get real and valuable pregnancy information. it doesn't seem to be that, though, and unless a policy happens that bad answers get deleted (which is not current askme policy) it doesn't look like askme is ever going to be that place.
posted by shmegegge at 9:04 AM on May 16, 2008


TedW, the somewhat fuzzy heart condition thing is the reason why, in that thread, I also suggested she cross-check with her doctor or pharmacist - I am not a doctor, but the POPs are supposed to eliminate or significantly decrease risk of cardiac events that can be an issue for the combination pill. The FDA leaflet guidelines don't list heart conditions as an contraindication but obviously that is something that should be assessed by a clinician.

Regarding guesstimating fertile days, well as we all know, you can get pregnant whilst having your period, so for the majority of women who are not charting with temps and cervical mucous, using fertility monitors, or taking ovulation stimulators with or without ultrasound monitoring, predicting when someone may ovulate is just a guess based on an idealised and averaged text book menstrual cycle.

You can have a text book 28 day cycle, and be someone who ovulates on day 5 or on day 20; I don't believe there is a way of knowing when in your cycle you ovulate unless you've investigated this. In addition, stressful events (like oh, say, pregnancy scares) can delay ovulation, making your period "late" and causing even more stress -- this is actually reasonably common.

But really, the bottom line is: they had unprotected sex. She should take EC if she's willing and medically able to do so (which I should have made clearer in my fake MeTa answer but hope I was clear on in my AskMe answers.) I am just failing to understand how that is debatable on any kind of scientific basis. Surely "I got lucky and you probably will too" experiences do not constitute good advice. Even more surely, answers that involve RU-486 and absolutes about bad EC experiences are more harm than good. Right?
posted by DarlingBri at 9:04 AM on May 16, 2008 [3 favorites]


If women could get pregnant as easily as some in that thread, and this thread, are supposing, the world would very quickly have an overpopulation problem.
posted by euphorb at 9:11 AM on May 16, 2008


shmegegge, honest question: Do you think it's better for someone to get no information at all about the likelihood of pregnancy and options like the morning-after pill, rather than have to wade through flat-out wrong info as well as correct info and being forced to make the (potentially wrong) decision themselves about what to believe?

I can honestly see people holding either view, although I'm pretty firmly in the second camp for all medical questions and *particularly* for medical questions involving women's health. I know there are mefites (including some docs) who have expressed that the most important principle here is to avoid giving bad info that people might act on, and although I really disagree with that, I can respect it. I just think supporters of that position need to acknowledge that there's a real possibility that the alternative isn't the OP skipping off to a doctor to get appropriate medical treatment, but rather that they'll not go to a doctor at all, which has its own risks of really negative outcomes.

I dunno. This strikes me as similar to the parental-consent laws for teenagers seeking abortion; of course in a perfect world we'd like it if every teenager had the sort of relationship with her parents that would allow for that, we don't live in that world. It'd be really great if every teenager (and adult) had access to unbiased, timely medical information about pregnancy and potential post-coital birth control options, but we don't live in that world, and making decisions as if we do doesn't seem (to me) to be the best way of handling it.
posted by iminurmefi at 9:28 AM on May 16, 2008 [1 favorite]


It's the poster child for unsafe sex, and EC is absolutely and immediately warranted.

You sound like a fundamentalist, because, well, you're reasoning like a fundamentalist. These folks had slightly unsafe sex. There's no aspect of it that's the poster child for anything, aside from bad judgment. The question was about probability, and you have answered it incorrectly by insisting that it's really a black or white question about safe or unsafe sex. If you can't answer the question as asked, then you should stay out of the thread and skip the moralizing MetaTalk threads.

(Just to put some perspective on my answer, I work in an STD clinic and just came from a two day conference on treating HIV/AIDS. I'm no fan of unsafe sex, but the situation as described sounds barely unsafe.)
posted by OmieWise at 9:43 AM on May 16, 2008 [5 favorites]


I appreciate the dude being scared and all, who's been sexually active for a while and hasn't had some sort of a OMFG IS SHE PREGNANT NOW scare raise their hands. But still, and I appreciate jessamyn's doubts, the question was a textbook example of unanswerable question leading to all-out chatfilter. "What are the chances she's pregnant" is unanswerable, nobody knows -- it'd be unanswerable even if we had more data (like, is the dude even fertile, because maybe he isn't, was the girl ovulating, etc). Also, as pointed out above, we're not doctors but strangers on the Internet -- and good luck for the inevitable lawsuits to a doctor who takes the risk of diagnosing people over the Internet, by the way.

The dude is shitting his pants, and my heart goes out to him even if he's been very dumb -- we're not talking about a condom that broke, we're talking about plain old Russian Roulette here -- but the question was unanswerable and needed to be deleted.

So the poster should bite the bullet, wait, and then he'll know. It sucks I know, but we're not here to assuage his fears by pretending to be able to answer his question.
posted by matteo at 9:46 AM on May 16, 2008


Do you think it's better for someone to get no information at all about the likelihood of pregnancy and options like the morning-after pill, rather than have to wade through flat-out wrong info as well as correct info and being forced to make the (potentially wrong) decision themselves about what to believe?

But that's not the choice for these people, in my opinion. Instead of no info at all, they'd simply be told, via email, to go to a professional. In America, there are Planned Parenthood offices everywhere which answer questions for free and respect privacy. I don't know what their options would be elsewhere in the world, but it seems reasonable to assume we could perhaps direct them to a source of good information on the web, be it information for professionals they could visit or simply a decent repository of pregnancy information. It'd be awesome if we could depend on mefites to provide that information when these questions come up, but since we apparently can't all they're getting is noise.

But, if there's a gun to my head and I have to choose, I'd say that I think it's better for them not to get any info at all from us. There are plenty of other places they can go to to get bad advice and mixed conflicting responses. I don't think we're doing anyone any favors by being one of those places. People come here expecting good help. When we don't provide it, I think it's only fair to them to let them know.
posted by shmegegge at 9:49 AM on May 16, 2008


She should take EC if she's willing and medically able to do so (which I should have made clearer in my fake MeTa answer but hope I was clear on in my AskMe answers.) I am just failing to understand how that is debatable on any kind of scientific basis.

Hmmm. Really? She should? How about debating it on a non-scientific basis?

I wonder if the woman in question might want to have and raise a baby, or be willing to put it up for adoption if she had one...? Just a thought.
posted by tristeza at 9:53 AM on May 16, 2008


I will be calling her doctor re: plan b to make sure it is safe for her to take

Did this weird anyone else out?
posted by amro at 9:54 AM on May 16, 2008


You misspelled 'abortifacient.'
posted by ikkyu2 at 10:21 AM on May 16, 2008 [1 favorite]


Did this weird anyone else out?

The wiping her off part weirds me out.
posted by Brandon Blatcher at 10:43 AM on May 16, 2008 [1 favorite]


DarlingBri: You can have a text book 28 day cycle, and be someone who ovulates on day 5 or on day 20;

But see, you're wrong here. The luteal phase (post-ovulation) is pretty much always 14 days in women; it's the follicular phase that varies. So you can't ovulate on day 5 and have a normal 28 day cycle.

I guess that just proves your point though.
posted by gaspode at 10:58 AM on May 16, 2008


Snap!
posted by ThePinkSuperhero at 11:38 AM on May 16, 2008 [1 favorite]


Also, DarlingBri, you're over in the yeast infection thread spreading incorrect information about yeast infection treatment, so please, heed your own advice.
posted by tristeza at 12:16 PM on May 16, 2008 [2 favorites]


This was a good talk.
posted by Brandon Blatcher at 12:21 PM on May 16, 2008 [1 favorite]


Did this weird anyone else out?

Yeah, between that and the wiping off with a paper towel and the offhand reference to medications, it's starting to remind me a little of Boxing Helena.
posted by dersins at 12:25 PM on May 16, 2008


Did this weird anyone else out?

Yes, also because some of his posting history indicates that he's a college graduate...yet she needs someone else to call the doctor for her?
posted by Miko at 12:54 PM on May 16, 2008


That's a relief. I peed on it and it turned blue so I was worried.

You have to click "Make It Stop" at the bottom.
posted by oaf at 12:57 PM on May 16, 2008 [1 favorite]


Yes, also because some of his posting history indicates that he's a college graduate...yet she needs someone else to call the doctor for her?

Seems to me she's any or all of: under 18, un(sex)educated, has no power with her doctor, no power within her family.

Also, DarlingBri, you're over in the yeast infection thread spreading incorrect information about yeast infection treatment, so please, heed your own advice.

What is this delicate aroma? Ah. Hoist. Petard, I believe?
posted by dirtynumbangelboy at 12:57 PM on May 16, 2008


You sound like a fundamentalist, because, well, you're reasoning like a fundamentalist. These folks had slightly unsafe sex.

Casting aspersions about being a "fundamentalist" is completely unwelcome.

Slightly unsafe sex? What, are we laying odds now? Or do you get only a little pregnant from "slightly unsafe" sex?

jackass. you don't need a hug.
posted by Cool Papa Bell at 12:57 PM on May 16, 2008


I think Ask MetaFilter has seen a huge uptick in the number of people who post something they think is true as though it is incontrovertibly true, even when it's wrong. See here and here.
posted by oaf at 1:05 PM on May 16, 2008


Slightly unsafe sex? What, are we laying odds now? Or do you get only a little pregnant from "slightly unsafe" sex?

I think "slightly unsafe sex" makes sense as a phrase.... unless you're 100% abstinent, then you're dealing with a risk spectrum - and messy virginal fumbling is a great deal safer than a great many other things.
posted by moxiedoll at 1:06 PM on May 16, 2008


Slightly unsafe sex? What, are we laying odds now?

From the original question:

"what are the chances she's pregnant?", "on a scale of 1-10, what are the chances she could get pregnant, with 10 being almost certain?"

So, yes. As horrible as that pun may be, it was about laying odds.
posted by CKmtl at 1:16 PM on May 16, 2008


Yes, also because some of his posting history indicates that he's a college graduate...yet she needs someone else to call the doctor for her?

And now he says he made her take the pill in front of him so he knew she took it. What happened to a woman's right to choose?
posted by amro at 1:23 PM on May 16, 2008


At long last, we finally know how babby is formed.
posted by Skot at 1:30 PM on May 16, 2008 [1 favorite]


And now he says he made her take the pill in front of him so he knew she took it.


That's not how the original poster described things. What he wrote was this: "I bought her the pill and she took them in front of me so I know she did it."
posted by Brandon Blatcher at 1:39 PM on May 16, 2008



I wonder if it isn't time to instate a "no pregnancy questions" rule?


Jesus, I *am* a doctor and when Mrs. Bartfast gets pregnant I plan on maxing out my question quota.

Dear MeFi, my wife won't allow any food in the house except Snyder's honey mustard pretzels what do I do?

Dear MeFi, I'm pretty sure my wife's pregnancy is giving her hemorrhoids because I hear her screaming in the bathroom. I'd like to help but I don't want to embarrass her...

Dear MeFi, my wife won't have sex with me anymore, what do I do?

Dear MeFi, my wife wants to have sex with constantly, what do I do?

Dear MeFi, I just witnessed the birth of our child and now I never want to have sex with my wife again, what do I do?
posted by Slarty Bartfast at 1:41 PM on May 16, 2008 [3 favorites]


And now he says he made her take the pill in front of him so he knew she took it.

That reads more defensive to me than anything else. "You guys, she took it. I saw her take it. Do not ask me if she really took it. I guess at the last possible second she could have switched it with a jelly bean or something; that's a possibility, sure. But. As far as I know. It was taken. Okay?" Given the tone of the thread, this is an understandable response.
posted by kittens for breakfast at 1:44 PM on May 16, 2008


We'll be here for ya, Slarty.
posted by stubby phillips at 1:51 PM on May 16, 2008


At long last, we finally know how babby is formed.

I laughed at that. God help me.
posted by cortex (staff) at 2:11 PM on May 16, 2008


Slarty Bartfast : Dear MeFi, I just witnessed the birth of our child and now I never want to have sex with my wife again, what do I do?

Didn't you know? Child birth is the destroyer of vaginas.
posted by quin at 2:16 PM on May 16, 2008


The luteal phase (post-ovulation) is pretty much always 14 days in women; it's the follicular phase that varies.

No, this isn't true either. The luteal phase is generally between 12 and 16 days. However, shorter and longer luteal phases are not unheard of, and shorter luteal phases (less than 12 days) are specifically associated with fertility problems.

Whatever the length of an individual woman's luteal phase, that's what's consistent -- i.e., while the follicular phase can vary for everyone from month to month (due to stress, illness, etc.), the luteal phase will almost invariably be the same length, whether it's 10 days or 16. I track my cycle, and my luteal phase most definitely isn't 14 days -- it's the exact same number of days every month, but that number isn't 14.
posted by scody at 2:19 PM on May 16, 2008


I think "slightly unsafe sex" makes sense as a phrase....
So, yes. As horrible as that pun may be, it was about laying odds


Except you're dealing with an outcome that is binary in nature -- you're either pregnant or not. Therefore, there is no such thing as "slightly unsafe." It's either zero or non-zero. You can reduce risk ahead of time, sure (hello condoms...), but the question was of the "what are the chances" nature after the fact.

The only answer is "you don't know, but it sure ain't zero."

And moreover, the only appropriate follow-up answer is, "now explore your mitigation options." Everything else is speculation and anecdote, which is what DarlingBri (and myself) are bristling at.

Like I said in the thread, you can either take the bullets out of the gun (EC) or you can wear a bulletproof vest (stand around and inquire about your odds). One is doing something, the other is hoping for something.
posted by Cool Papa Bell at 2:20 PM on May 16, 2008 [1 favorite]


Except you're dealing with an outcome that is binary in nature -- you're either pregnant or not. Therefore, there is no such thing as "slightly unsafe." It's either zero or non-zero.

Some things are more dangerous than other things, right? You're either dead or you're alive but on the spectrum of things that could lead to death, jumping off a building is more unsafe than speeding on the highway. Neither is "safe" - people die of both things - but the second is safer than the first. it's a change in thinking in public health that's been around at least a decade - there's really no such thing as "safe sex" - but some things are safer than others.
posted by moxiedoll at 2:38 PM on May 16, 2008


The potential outcome may be binary, but the risk assessment is not.

In terms of risk of pregnancy, what they did was 'slightly unsafe'. At opposite end of the spectrum would 'stupendously unsafe', such as having literally round-the-clock unprotected internal-ejaculation sex, with as many men as it would take to sustain that pace, for the complete duration of her menstrual cycle. Both unsafe, but to different degrees.

Similarly, you'll either catch the flu or you won't, but some behaviours are riskier than others: being in the same room as an infected person for a fraction of a second vs. licking doorknobs and snorting people's coughs during flu season. Slight risk of infection and stupendous risk of infection.
posted by CKmtl at 2:41 PM on May 16, 2008


I didn't see any of the answers directed at WHAT THE WOMAN WANTS TO DO. Advising her to take EC is kind of stupid if she's OK with getting pregnant, or if her beliefs prohibit her from taking EC.
posted by desjardins at 2:41 PM on May 16, 2008


OK, I read the followup from the OP and evidently she's cool with taking EC, but I can't believe no one wondered aloud what SHE wanted. It seemed to be all about the dude not wanting to be a dad.
posted by desjardins at 2:47 PM on May 16, 2008 [1 favorite]


It seemed to be all about the dude not wanting to be a dad.

The OP was the one asking the question and it seemed fairly obvious from his presentation that her not being pregnant was what would put his mind at ease. Wondering aloud what his gf wants takes it out of the realm of "hey let's try to give you some concrete information to help you understand what is going on here" (because I really believe there are a lot of people, online and not, who literally don't have enough of a toolkit with these things to evaluate risks on their own, we can help with that) and well into the "hey let's get all up in your business/plans"

I should qualify what I said upthread, I'm totally okay with people asking tons of random questions about pregnancy generally [and look forward to yours, Slarty Bartfast] but this whole "Do you think I/she is/am pregnant, here are the details of our last sexual experience together..." type of question just doesn't do anything worthwhile and gets people huffy. A similar type of question is the "I'm pregnant and I know XYZ behavior is risky but how risky is it...?" which often makes people flip out.

I realize that some of these questions exist to put the OPs mind at ease before they can actually get a bona fide answer (which they will do as soon as possible) and that's one sort of information need, but the "put my mind at ease in lieu of me actually talking to a specialist" questions are starting to get outside the realm of what AskMe should be doing, imo.
posted by jessamyn (staff) at 2:56 PM on May 16, 2008


Honestly, AskMe is like a cocktail party. It's unfortunate if someone believes they are getting reliable advice about something important like a medical problem. That doesn't negate the value in polling a bunch of people in a social setting about something that troubles them. Ultimately, after hearing a number of opinions this guy did what most reasonable people would do so no harm, right?

I don't know how I feel about shouting people down who are saying something that rings true for them. Many people have experienced that EC causes nausea. Reasonable non-professional statement. The risk of pregnancy with non-penetrative sex is lower than intercourse, but not zero. Reasonable non-professional statement. I saw this thread and there was no "correct answer," it was basically chatfilter, and having no direct experience in this situation, I decided to stay out of it. Like I said, I don't know how I feel about making a big MeTa out of it. I mean I'm not sure I see anything that rises to the level of wildly inappropriate.

The problem seems to be mistaking social opinion with professional advice and this is ground that has been well trod around here.
posted by Slarty Bartfast at 3:23 PM on May 16, 2008 [1 favorite]


roofus' answer was basically perfect! Just thought that needed to be said.
posted by Chuckles at 4:27 PM on May 16, 2008


Yeah, that was pretty cool. "Here's a journal article I wrote about this exact situation..."
posted by Slarty Bartfast at 4:30 PM on May 16, 2008


who's to say it's a scientific problem in the first place? maybe it's a probability problem. maybe it's a statistical problem. science may not enter into it, and if it does, why is a doctor somehow the president of science?

personally, i think it's a spiritual problem.
posted by stubby phillips at 5:29 PM on May 16, 2008


If everyone isn't already tired of this topic - I'd love to know this:
Roofus' answer was awesome in its perfection - but I don't understand why I'm reading it differently than everyone else. Everyone agrees that pregnancy can, technically occur without intercourse - but everyone drew the conclusion, "it can happen! look! an article in a medical journal!" while it seemed more to me, like, "it can happen - but look. if it happens to you, they'll write about you in a medical journal." they don't write a case study about how you got pregnant unless you got pregnant in a really weird way - I don't get why the existence of the article doesn't put a tick in the "don't worry about it" column.
posted by moxiedoll at 6:09 PM on May 16, 2008


...which is to say that i disagree with brianna and icky.

folk medicine is usually all we get. during those three to seven weeks before we get to see a "doctor", we talk to friends and family and metafilter. the advice is usually good, and we are generally "cured" before we even get to wait those agonizing hours upon hours in the waiting room. then there's the deductible, the copay, and the disappointment.

i think that getting the perspective of healthy adults who have no financial interest in the outcome is valuable. whether or not it's more valuable than the advice of a physician is arguable, i suppose.
posted by stubby phillips at 6:12 PM on May 16, 2008


Except you're dealing with an outcome that is binary in nature -- you're either pregnant or not. Therefore, there is no such thing as "slightly unsafe." It's either zero or non-zero.

This is kind of dumb, actually. If you jump out of a plane without a parachute, the "do I die?" outcome is also binary in nature; you either die or you don't. Therefore, there is no such thing as "very dangerous" jumping out of airplanes without a parachute? If somebody falls out of an airplane at 20,000 feet with no parachute and survives, it wasn't unsafe?

In other words, you're looking at probability wrong. If I flip a coin it is either heads or tails. That doesn't mean if somebody asks, "I flipped a coin and haven't looked at it yet. What are the odds it came up heads?" that the answer isn't 50%.
posted by Justinian at 6:19 PM on May 16, 2008


I totally agree with your interpretation, moxiedoll, but on the other hand.. The fact that roofus' answer is open to the varied interpretations is a major part of its awesomeness. I mean, if you are the kind of person who can't deal with the ambiguity of "it is really, really unlikely", then you are probably the type of person who needs to be more careful and take action. Or get therapy, but that is a different AskMe question :P
posted by Chuckles at 6:31 PM on May 16, 2008


The best part of this thread is that DarlingBri rants in MetaTalk about spreading misinformation in AskMe while doing the exact same thing! Comedy gold.
posted by Justinian at 7:01 PM on May 16, 2008 [1 favorite]


Justinian, those are tortured analogies and don't refute anything. Here, let me help you:

1) A coin flip will decide whether you live or die. You flip the coin, but before you look at it, you ask me what are the odds its heads, because if it's heads, you die. I say, "No one can tell you whether it's heads or tails with more than 50-50 accuracy. What I can tell you is that NOW THAT YOU'VE ALREADY FLIPPED THE COIN, IDIOT, if you take this inexpensive, safe pill, the odds go to 99.9999 percent you'll live, no matter what the coin flip was. Unfortunately, the pill has a 72-hour expiration date. Now, do you want the pill, or do you want to stand around and ponder the probability of heads or tails?"

2) You flip the coin, as above. Then you ask, "Well, geez, I don't want to die -- how safe was that coin flip?" Someone answers, "Well, you'll probably be OK. I've flipped lots of coins without any trouble. You'll be OK. Go ahead and look at it." So, now that Jackass No. 2 has shared with you his personal anecdote about coin-flipping, what are the odds it's tails?
posted by Cool Papa Bell at 7:02 PM on May 16, 2008


That doesn't mean if somebody asks, "I flipped a coin and haven't looked at it yet. What are the odds it came up heads?" that the answer isn't 50%.

It's been a long time since I took finite math, but isn't that in fact the correct answer? Or expressed differently, 1:1. That is, there is a 50% likelihood that it's heads, and a 50% likelihood that it's tails - and you won't know which until you look, but that doesn't change the fact that the odds were even.

The difference between jumping out of an airplane and having sex is that the risk of becoming pregnant through sexual activity has a lot more variables. Unless you want to point out the potential variables for the airplane scenario, too - is the airplane sitting on the tarmac? If so, the probability of death is pretty low. Is the airplane 3,000 feet in the air? Different probability of death. Similarly with sex: the probability of pregnancy occurring differs depending on many variables such as frequency of intercourse, degree of fertility/point in cycle, sperm viability, amount of ejaculate, etc.

I came down on the DarlingBri side because yes, it's possible. It's just possible, but there are women who have gotten pregnant when (as it turned out happened) using withdrawal, and if you need to reduce the possibility that you're pregnant to zero, there are only a few ways of doing that.
posted by Miko at 7:05 PM on May 16, 2008


"... Now, do you want the pill, or do you want to stand around and ponder the probability of heads or tails?"

That pill, or the EC one, is irrelevant to the risk, odds, or probability. You didn't criticize OmieWise earlier for saying the pill shouldn't be taken; you criticized him for saying it was "slightly unsafe sex".
posted by CKmtl at 7:17 PM on May 16, 2008


Cool Papa Bell: But your analogies aren't equivalent either. There is a non-zero risk if the woman is question did nothing. There is also a non-zero risk from taking the pill. The question is which risk is higher, and the odds of a pregnancy being caused by what took place is sufficiently low that it isn't clear which is the greater risk.
posted by Justinian at 7:28 PM on May 16, 2008


Oh, and...

Miko, I think the point Justinian was trying to illustrate was that, if the outcome has already occurred but is unknown (the flipped coin has already landed on either heads or tails, the asker's girlfriend's egg either has or hasn't been fertilized, etc.), the probability of either outcome is unaffected.

If you buy a scratch lotto ticket, the prize (or lack thereof) is already printed on the card, but you still have a 1 in N chance of your ticket being a winner. The end of the coin flip does not change the 50% odds, and the sex being over doesn't change the risk of pregnancy from "just barely possible" to "OMG BABBY IS FORMING!"
posted by CKmtl at 7:40 PM on May 16, 2008


you criticized him for saying it was "slightly unsafe sex".

I did, and I think it was warranted. The relative safety is irrelevant because the question pertains to a non-zero situation. Saying it was "slightly unsafe" after the fact muddies the issue. "Oh, if it was only slightly unsafe, I'll be OK. I don't need to upset my girlfriend or anything. I'll just pretend this never happened." Baloney.

Moreover, OmieWise was being a jackass.

The question is which risk is higher

Now you're moving the goalposts. But I think a .01 percent risk of pregnancy is outweighed by a 1 percent chance of a negative EC pill reaction. If you can't see that point, I can't help you.
posted by Cool Papa Bell at 7:50 PM on May 16, 2008


It muddies no waters. His comment was in this thread, not in the AskMe one. He didn't even post to that one. Also, the couple has already acted on the EC advice.

And it is relevant to the question, because the question was about probability, odds, risk. You yourself said in the AskMe thread that pregnancy resulting from that encounter is "indeed extremely unlikely".

Your beef with him about the relative risk / probability of pregnancy is unfounded.
posted by CKmtl at 8:07 PM on May 16, 2008


You yourself said in the AskMe thread that pregnancy resulting from that encounter is "indeed extremely unlikely".

Thank you for conveniently ignoring my first post to the thread -- "No one will be able to tell you with 100 percent accuracy. She should look into morning-after medications." And the fact that the second post started off with a "let me clarify my first point..."

Your beef with him about the relative risk / probability of pregnancy is unfounded.

You know, forget medicine. You guys would make terrible defense attorneys.

"I've been arrested for murder!"
"You'll be OK."
"Well, shouldn't we prepare a case or something?"
"Nahh. Lots of people get arrested."
"But my fingerprints were found at the crime scene..."
"You know, attorneys fees can be quite expensive..."
"But they're talking about the death penalty! Shouldn't we do something?"
"Oh, come on. Relax! How many people are really put to death in this country?"
posted by Cool Papa Bell at 8:32 PM on May 16, 2008


CPB it seems like *you're* saying that a person in the situation you outlined (fingerprints at scene, arrested for murder, talk of death penalty) is in THE SAME SITUATION as someone who shows up and says "look, I haven't done anything, and no one suspects me but it's possible that I could be framed for murder and arrested and charged and tried and executed!" They aren't the same, right? You're either executed by the state or not.... it's binary.... and it's possible that you could be executed by the state whether or not you committed a crime.... but whether it makes any sense to prepare a defense depends on the circumstances, right?
I think that's the issue. You maintained (it seems) that once there's a non-zero chance of an outcome it no longer matters what the circumstances that lead to that non-zero chance are (and therefore - it doesn't matter how far from zero that chance is). If you agree that some activities are slightly unsafe, and others are horribly dangerous, then I don't think there's any quarrel. But it seemed like you were saying that all risks are created equal, which isn't true.
posted by moxiedoll at 8:45 PM on May 16, 2008


If we want to take full risk assessment into account, then driving to the store to buy the damn emergency contraception is a bigger real threat to these cats than that silly droplet of wayward cum.

You see because driving is statistically very dangerous, while the realistic odds of pregnancy here (loud, innumerate fundy clucking aside) are objectively very low. And, even so, pregnancy can also be dealt with later with an awesome abortion, which it turns out, is legal. Ya dig?

So just lick the semen drop off her pussy lip, for Jesus' sake, roll over and go to sleep. The world keeps on spinning, and you're both fine. Relax or the accumulated stress will kill you one day.

I don't see how anyone ever actually enjoys sex with this constant Chicken Little stress over babbys.

By the way, if you are having regular sex and condoms are your only method of birth control, and you are a typical person, there is a 14% chance your girlfriend will get pregnant in the next year. 14%! So the odds of pregnancy from normal protected sex, over a surprisingly short period of time, are much, much higher than your experience with the labial itinerant.

And yet no one is recommending you go out and take emergency contraception every time you have "protected" sex, even though the accumulated odds over a short time are much worse for you. I wonder why that is?

The best option is hormonal birth control, which makes babby and ejaculation a trivial concern. Do it. Do it now.

PS - Half of women have an unintended pregnancy in their lifetime, and one-third have at least one abortion. It's life, be ready for it, and don't sweat it. They are simple, unremarkable procedures.

posted by dgaicun at 2:37 AM on May 17, 2008 [2 favorites]


In the spirit of this thread, I'm donating $200 to Planned Parenthood. Also buying a glock, but that's a separate issue.
posted by stet at 2:56 AM on May 17, 2008


I find it really funny that DarlingBri hasn't shown up since this. Do we have a MeFi Dunce Cap maybe?
posted by dirtynumbangelboy at 8:35 AM on May 17, 2008


dnab, if we go down that road we're going to need an awful lot of hats. Somewhere upward of seventy thousand is the current count.
posted by cortex (staff) at 9:03 AM on May 17, 2008 [2 favorites]


Hmm, I smell a new product for the cafepress store..
posted by dirtynumbangelboy at 9:05 AM on May 17, 2008


user number across the front in 36-pt Verdana, under the smiling mug of quonsar...
posted by cortex (staff) at 9:14 AM on May 17, 2008


hahaha..

MetaFilter Dunce #18307
"I have quonsar's fish in my pants"
posted by dirtynumbangelboy at 9:25 AM on May 17, 2008 [1 favorite]


Atypical condom usage.
posted by Tube at 9:41 AM on May 17, 2008


So your second link would be the MeFi dunce cap dirtynumbangelboy alluded to? Seventy thousand should be reasonably afforable if we get enough donations.
posted by TedW at 2:39 PM on May 17, 2008


As other people are point out here, the problem with your argument, CPB, is that no form of sex is completely safe, which is why some groups have ditched the 'safe sex' label for 'safer sex'. You seem to be arguing that any form of less than perfect safety is reasonably conflated monolithically as unsafe, and taking offense to anyone who wants to put a gradation on that. Your murder-charge analogy seems more analogous to say, unprotected internal ejaculation than it does to what actually happened here, which is legitimately on the safer side of a lot of possible sexual activity. To conflate all possible variations of sexual unsafety like you're doing seems counter to an actual understanding of the risks involved, and overly reductive.
posted by Arturus at 1:50 AM on May 18, 2008


Could people please stop giving medical advice with no basis in science

No. No, they could not.

Can we all get our pants fish and go home now?
posted by ikkyu2 at 9:11 AM on May 18, 2008


>By the way, if you are having regular sex and condoms are your only method of birth control, and you are a typical person, there is a 14% chance your girlfriend will get pregnant in the next year.

My girlfriend? Not my wife?

Leaving aside your rather strange characterisation of the relationship, the page you linked to says something more interesting and less scary:

>"Typical Use" rates mean that the method either was not always used correctly or was not used with every act of sexual intercourse (e.g., sometimes forgot to take a birth control pill as directed and became pregnant), or was used correctly but failed anyway.

So "Typical use" actually means something as broad as "used sometimes but not always".
posted by AmbroseChapel at 10:44 PM on May 18, 2008


Casting aspersions about being a "fundamentalist" is completely unwelcome.

Perhaps you don't know that fundamentalism need not be merely a religious designation?

I can't help you with the relative risk thing. Binary outcomes do not obviate relative risk, even if they may change how we make our assessment. This is, in fact, how all birth control works, since almost all methods have a non-zero chance of resulting in pregnancy. No rational person talks about having sex while on the pill, or with a correctly used condom, as high risk (for pregnancy), despite the still-binary outcome. I think you're confusing your desire to think I'm wrong with me actually being wrong.
posted by OmieWise at 4:10 AM on May 19, 2008 [1 favorite]


shmegegge: "I wonder if it isn't time to instate a "no pregnancy questions" rule?"

More rules are almost never the correct answer to any question you care to name. Unless the question is "what would almost certainly make this situation worse?"
posted by dg at 5:04 AM on May 19, 2008


My girlfriend? Not my wife? Leaving aside your rather strange characterisation of the relationship, the page you linked to says something more interesting and less scary:


1) I am not aware how the nature of their relationship, be they husband and wife or one-night stand, changes the probability that a goo drop on the taco flap will result in pregnancy. I am not aware why you believe any given characterization of their relationship is relevant here at all.

2) I explicitly said if he was the 'typical person' that would be his risk according to my link, which defines 'typical use' right at the top. So there you go. It isn't hard to look at the chart.
posted by dgaicun at 7:58 PM on May 19, 2008


Why should we censor our honest answers to questions? If someone is dumb enough to take free advice from the internet about anything, isn't that their fault?
posted by gjc at 7:30 PM on May 27, 2008


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